This is a blog by a former CEO of a large Boston hospital to share thoughts about hospitals, medicine, and health care issues.

Tuesday, August 02, 2011

Five years running

Today marks the fifth anniversary of this blog. Little did I realize when I offered my first post that it would evolve into a personal compulsion. Even less did I understand the power it would have as a leadership tool within my hospital and the impact it would have more generally in the health care field.

I started this blog because I had an interesting job (CEO of a hospital) in a fascinating field. Being new to the field myself, I thought that other people might like to have an insider’s view of what was going on in an academic medical center. The blog would also require me to think clearly about what I was learning so I could synthesize things for my readers.

What readers? At the beginning, there were a few, mainly the lawyers and press people in my hospital who had an underlying fear that I would say something illegal, inappropriate, or downright dumb. I knew they had nothing to fear on the first two points, but on the third, they had every right to be nervous!

I learned how to generate traffic for my blog. First, I sent an email to my 500 closest friends, letting them know about it and asking them to tell others. Second, I created linkages to other health care bloggers. Third, I tried to write something interesting so people would come back for a second visit.

The breakthrough moment, though, came when Boston Globe business reporter Chris Rowland wrote an article about the blog in his newspaper. Privately, he also told me that my posts were a bit boring and that I needed to spice things up a bit. From then on, it was off to the races, as you can see in this traffic report from the days right after his story. (In those days, I eagerly counted page loads in the hundreds rather than thousands!)

When I left my job at the hospital this past winter, quite a number of you wrote to me and expressed hope that I would maintain the blog. Because of you, I did so, and I have been pleasantly surprised to see that viewership has continued to grow. My topics have become less Boston-centric (except where Massachusetts offers broader lessons). Also, of course, I no longer present inside stories about my former hospital. I now consider myself an unabashed advocate for those causes mentioned in the masthead. In that capacity, I am more free to be even more direct than before (if that is possible!) about things that matter to patients and families, and also to doctors, nurses, and other people involved in the delivery of care.

I have found, too, that many of you are eager to join in by sending me story ideas from your regions -- events and concepts that you know are important to your constituencies and more broadly. I welcome those suggestions and promise to maintain your confidentiality as I rewrite them for the general audience.

The blog has also turned into a bit of a magazine over the years, with other topics of interest to me and, I hope, to you. You don’t have to stick with me very long to know of my passion for soccer, infrastructure, civil rights, effective government, good food, and nature. I hope that the articles on those topics provide a nice break for you, as they do for me. After all, you can’t talk about health care all the time!

It is traditional, on this kind of anniversary, to cite those blog posts that have generated the most interest, in terms of traffic and/or comments. I demur on that point. Each of you has your favorites -- and the ones you hated -- and it serves no purpose to give you my summary right now (although that may come in a future book on the value of social media for those in leadership positions.)

For now, I simply offer my thanks to you -- regular readers, occasional readers, newly arrived readers -- for allowing me the privilege to let this site provide useful, informative, or entertaining content in your lives.

And for my colleagues in arms, the other health care bloggers out there, a special thank-you for your friendship, collegiality, support, and good humor as we together try to transform the health care system into what we would want for members of our own families. There is a long way to go, but there is no more worthwhile endeavor.

Vanessa: Thank you for the Blog, it's an eye opener. As a Regis Health Administration student this fall, I will think of my experiences I had at BIDMC and the challenges we faced as a team, lead by a great leader. It will be great to use these experiences as a learning tool!!! Thanks!

As undoubtedly your most big-mouthed commenter, may I offer my congratulations and gratitude for all those entertaining and enlightening posts. You have done a great deal to change medicine for the better - don't stop.

Paul, it’s hard to believe your blog is 5 years old… seems like so much more. You’ve inspired us, provoked us, frustrated us, and more. You introduced the notion of a culture of candor when most were still saying “you want to do what—no way!” In the spirit of all teach all learn, you’ve welcomed front line staff, patients, and members of the public with international thought leaders. We all know more about infrastructure than we ever imagined. Yes, interestingly enough, we saw through it. That is also the foundation that we need to build high performance high commitment healthcare on. Then there were always the celebrations of patients, family members, front line staff and communities; their struggles, their victories, their smiling pictures, their impact. I never had thought to photograph the elements along the sandy beach—you showed me what I missed.I’ve also seen the impact of your site in the classroom, as a reality tv teaching tool on the diversity and pulsating nature of leadership and management. You dealt before us with not only what was planned but what you were confronted with. Finally, you kept the blog postings short with impact and avoided the trap so many have found of the elusive mini-book.Thanks so much for all you have taught us and I look forward to the next chapters. I still haven’t done my first TWEEET; that can be a goal for the next 5 years!

Your post/letter about the effects of the economy on BIDMC and your efforts to include the staff in outlining the solutions: http://runningahospital.blogspot.com/2009/03/update-on-economy-and-its-effect-on.html

Your discussions about how you manage (cope) a hospital:http://runningahospital.blogspot.com/2007/06/how-we-manage.html

The post on recapitalizing not-for-profits with for-profit equity:http://runningahospital.blogspot.com/2011/02/i-was-not-skeptical-enough.html

Today's post on the time value of money is another great one:http://runningahospital.blogspot.com/2011/08/what-is-value-of-40-million.html

Mix that in with a couple of posts about obnoxious parents or coaches in a kid's soccer league, a tale of mushroom hunting, and a passion for quality and you've got a blog that I look forward to reading during the next 5 yrs.

Paul, congratulations on reaching the five year anniversary mark. For several years I have enjoyed reading your observations, thought and ideas to make an improvement in the environment where you live and work. Whenever one of your publications has an idea that I believe will benefit our hospital and patients I route it onto the department managers for their consideration and implementation.

I think I would tell you that you have been a very big assistance to me, and I hope you continue to publish the blog and enjoy putting it together for many more years to come. You have a significant impact on all of us who manage hospitals…you cause us to think and that’s good.